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The role of esophagoscopy and imaging in the detection of second esophageal primary carcinomas in mucosal head and neck malignancy.

Anish Parek, MD,Arnold Lee, MD, Elie Rebeiz, MD
Tufts Medical Center- Department of Otolaryngology; Boston, MA


PURPOSE OF STUDY:
Esophagoscopy and/or barium swallow are routinely performed in the evaluation of patients with mucosal head and neck malignancies. Whether this intervention is efficient or cost-effective is often question in out multidisciplinary head and neck tumor clinic. Our objective in this study is to find the yield provided by esophagoscopy and barium swallow, and the incidence of second primary cancers.

METHODS USED:
A retrospective chart review was done on patients treated at our institution for squamous cell carcinomas of the oral cavity, oropharynx, hypopharynx, or larynx between January of 1992 and December of 2000. The records of five hundred and ninety-four patients were analyzed to determine the method by which the cancer was diagnosed, the association with a particular region of the primary cancer, and the incidence of risk-increasing behavior.

SUMMARY OF RESULTS:
Five patients (0.84%) were found to have a second neoplasm of the esophagus at some point during their clinical course. Of these, three patients (0.5%) had metachronous and two (0.34%) had a synchronous lesion. Three were diagnosed with barium swallow and two during routine endoscopy. The primary tumors were of the oral cavity in three patients and of the glottis and/or hypopharynx in two patients. All patients had a history of tobacco or alcohol abuse.

CONCLUSIONS:
There is a very low incidence of a second cancer of the esophagus. Barium swallow appears to be a safe and reliable method to detect an esophageal lesion.

 

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